Valproic Acid

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General Principles

Valproic acid (VPA), an anticonvulsant, is widely used for the management of seizures and mood disorders and exerts its effects by inhibiting the function of voltage-gated sodium and calcium channels as well as enhancing the function of GABA.

Pathophysiology

VPA is metabolized by the hepatocytes through a complicated biochemical process that involves β-oxidation in the mitochondria. This drug may result in fatty infiltrates in the liver and accumulation of ammonia.

Risk Factors

Hepatic dysfunction can occur even at therapeutic levels and therefore should be monitored. The therapeutic range is 50–100 mg/L. In overdose, the risk of hepatic dysfunction and hyperammonemia increases.

General Principles

Valproic acid (VPA), an anticonvulsant, is widely used for the management of seizures and mood disorders and exerts its effects by inhibiting the function of voltage-gated sodium and calcium channels as well as enhancing the function of GABA.

Pathophysiology

VPA is metabolized by the hepatocytes through a complicated biochemical process that involves β-oxidation in the mitochondria. This drug may result in fatty infiltrates in the liver and accumulation of ammonia.

Risk Factors

Hepatic dysfunction can occur even at therapeutic levels and therefore should be monitored. The therapeutic range is 50–100 mg/L. In overdose, the risk of hepatic dysfunction and hyperammonemia increases.

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